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Agentic artificial intelligence (AI) systems capable of autonomous goal-directed behavior, multi-step planning, tool use, multi-agent coordination, and iterative self-correction represent a transition from passive clinical AI tools toward systems that can participate in complex healthcare workflows. However, empirical evidence remains fragmented across clinical decision support, patient monitoring, and administrative applications, and no systematic synthesis has evaluated which agentic principles have been technically demonstrated and which have accumulated sufficient evidence to support responsible clinical deployment. We conducted a PRISMA-informed systematic review of peer-reviewed empirical studies published between January 2025 and April 2026. Searches across five bibliographic databases and Google Scholar, supplemented by citation tracking, identified 443 unique records for screening, of which 25 met the predefined PICOS and quality appraisal criteria. Evidence was synthesized using an evidence-informed seven-principle framework derived from the integration of agentic AI, clinical AI, and healthcare governance literature. This framework provides a structured lens for examining how agentic principles are evaluated individually and in combination, enabling a deployment-readiness perspective that extends beyond capability-focused assessments alone. The evidence base was concentrated on technical capability principles, whereas human oversight, safety, compliance, and equity-related evaluation received comparatively limited attention. Most studies remained at the laboratory, benchmark, or proof-of-concept stage, and none reported demographic-stratified performance outcomes. Overall, the findings suggest a structural asymmetry in agentic healthcare AI: empirical research is advancing agentic capabilities more rapidly than it is generating evidence for the oversight, safety, equity, and governance mechanisms required for responsible clinical translation.

This study aims to obtain a comprehensive understanding of the Juz ‘Amma memorization strategy implemented at Madrasah Diniyah Takmiliyah Baitul Azhar, evaluate its effectiveness, and examine the assessment mechanisms applied in Qur’anic learning. The research employed a qualitative field-study approach, focusing on learning activities as the primary object of investigation. Data were collected through direct observation of the learning process, in-depth interviews with the madrasah principal and teachers (ustadz/ustadzah), and documentation analysis related to the memorization program. The data were analyzed through data reduction, data presentation, and conclusion drawing to generate accurate and in-depth findings. The results indicate that the memorization program utilizes a combination of talaqqi, takrir (repetition), sima’i, and small halaqah methods. These strategies have proven effective in improving students’ memorization abilities, as reflected in increased reading fluency, better tajwid accuracy, and the achievement of memorization targets. In addition, the madrasah implements a structured and continuous evaluation system consisting of daily assessments, weekly reviews, and final examinations for each juz. The evaluation focuses on memorization fluency, recitation accuracy, and overall memorization quality. The study concludes that integrating diverse memorization methods with systematic evaluation significantly enhances the effectiveness of Qur’an memorization learning in Islamic educational institutions.  

This study aims to analyze the effect of the implementation of the Flipped Classroom model with a Deep Learning approach on the critical thinking and collaboration skills of Phase F XI students on the digestive system material. The study used a mixed methods with an embedded experimental design type. The research sample consisted of one experimental class that received Flipped Classroom learning with a Deep Learning approach and one control class that received Problem Based Learning (PBL) learning. Data on critical thinking skills were collected through essay tests, while collaboration skills were obtained through observation sheets. Quantitative data analysis used One-Way MANCOVA and qualitative analysis was carried out through data reduction, data presentation, and drawing conclusions assisted by NVivo. The results showed a simultaneous significant effect between the learning model on students' critical thinking and collaboration skills after controlling for initial abilities with a significance value of 0.002 (p<0.05). The average posttest critical thinking of the experimental group was 71.69 higher than the control group at 62.53. Meanwhile, the collaboration skills of both groups showed a relatively balanced increase. The ANCOVA results showed that the Flipped Classroom model with a Deep Learning approach significantly impacted critical thinking skills, but did not show a significant difference in collaboration skills. The research findings indicate that the integration of Flipped Classroom and Deep Learning is effective in improving students' critical thinking skills and supporting 21st-century learning.

In today's digital era, MSME actors are required to be able to compete through the use of technology, including in building a brand image through digital branding. This study aims to analyze the effectiveness of digital branding in increasing the competitiveness of Sambal Pecel Kanaya MSME products in Makassar. The method used is descriptive qualitative with data collection techniques through observation, in-depth interviews, and documentation. Data analysis was carried out using the Miles and Huberman interactive model which includes data reduction, data presentation, and conclusion drawn. The results of the study show that the digital branding applied is quite effective in building a strong brand image, expanding market reach, and increasing consumer trust and buying interest. The use of social media, visual content, authentic product narratives, and customer testimonials has been proven to support increased product competitiveness. However, there are still shortcomings such as limited visual design and the lack of optimal use of other digital platforms. Therefore, it is recommended that MSMEs increase branding capacity through digital marketing training and platform diversification to strengthen the brand's position in the wider market.

This study examines human resource competence in improving financial management at the Public Service Agency of Gorontalo State University, a public higher education institution that operates under a flexible financial management model while remaining accountable for public funds. The main problem addressed is how financial management personnel translate regulatory knowledge, technical skills, and professional attitudes into efficient, effective, and accountable financial governance. This study aims to analyze the competence of financial management personnel and explain its contribution to strengthening institutional financial management. A qualitative descriptive approach was employed through interviews, observation, and document analysis involving bureau leaders, financial work team officials, treasurers, and financial managers across relevant work units. The findings show that knowledge competence is reflected in personnel understanding of regulations, policies, financial systems, budgeting procedures, reporting requirements, and the linkage between budget and institutional performance. Skills competence is demonstrated through financial administration, transaction recording, document verification, use of financial information systems, reconciliation, reporting, and preparation of accountability documents. Attitudinal competence appears in professionalism, compliance, integrity, prudence, responsibility, and openness to evaluation and audit. Financial management has been directed toward performance-based planning, expenditure control, budget realization monitoring, reporting, supervision, and audit follow-up. However, challenges remain in regulatory adaptation, system integration, data quality, document timeliness, account-code accuracy, inter-unit coordination, and consistency of audit follow-up. The study concludes that strengthening human resource competence is essential for improving financial management that is efficient, effective, accountable, and performance-oriented in public university financial governance.

Non-Communicable Diseases (NCDs) such as Diabetes Mellitus and Gout pose a serious threat to the health of the elderly due to their often asymptomatic nature. Cost barriers hinder the elderly community from accessing laboratory services. This community service activity aims to improve health standards and early detection of NCDs through monitoring blood glucose and uric acid levels in the Generasi Kaleb community of the JKI Injil Kerajaan Church, Semarang. The Participatory Health Screening and Education method used includes health education, screening using the Point of Care Testing (POCT) tool, and personal consultation on the results. The service subjects were 50 elderly respondents. The examination results showed a prevalence of abnormal random blood glucose (GDS) of 8%, 32%, had high uric acid levels with a maximum value of 10.3 mg/dL. This activity successfully transformed the elderly's awareness from subjective perception to awareness based on objective data, and encouraged community independence in managing a healthy lifestyle to prevent further NCD complications. .

Penelitian ini bertujuan untuk menganalisis penerapan model Problem Based Learning (PBL) dalam pembelajaran Pendidikan Agama Islam di SMK N 1 Abung Selatan, Lampung Utara, serta pengaruhnya terhadap keaktifan dan hasil belajar siswa. Latar belakang penelitian ini didasarkan pada masih rendahnya partisipasi siswa dalam proses pembelajaran PAI yang cenderung berpusat pada guru. Oleh karena itu, diperlukan model pembelajaran yang mampu mendorong siswa berpikir kritis, aktif, dan mampu memecahkan masalah yang berkaitan dengan kehidupan sehari-hari. Penelitian ini menggunakan pendekatan kuantitatif dengan metode eksperimen semu (quasi experiment) melalui desain pretest-posttest control group. Subjek penelitian adalah siswa kelas XI yang dibagi menjadi kelas eksperimen dan kelas kontrol. Teknik pengumpulan data meliputi tes hasil belajar, observasi keaktifan siswa, dan dokumentasi. Data dianalisis menggunakan uji statistik untuk mengetahui perbedaan hasil belajar antara kedua kelompok. Hasil penelitian menunjukkan bahwa penerapan model PBL dalam pembelajaran Pendidikan Agama Islam memberikan pengaruh yang signifikan terhadap peningkatan hasil belajar dan keaktifan siswa. Siswa pada kelas eksperimen menunjukkan kemampuan berpikir kritis yang lebih baik serta keterlibatan yang lebih tinggi dalam proses pembelajaran dibandingkan dengan kelas kontrol. Dengan demikian, model Problem Based Learning dapat menjadi alternatif yang efektif dalam meningkatkan kualitas pembelajaran Pendidikan Agama Islam di SMK.

The keywords are required for computerization. Research and abstract title search made easy with these keywords. This study aims to determine the application of the entrepreneurship-based Project-Based Learning (PjBL) model to improve students' critical thinking and collaboration skills in Biology lessons at MAN 2 Tanjung Jabung Timur. This study used the Classroom Action Research (CAR) method, implemented in two cycles: Cycle I and Cycle II. Each cycle consisted of planning, implementation, observation, and reflection. Data collection techniques included observation, assessment, evaluation, reflection, and observation sheets for students' critical thinking and collaboration skills. The results showed that the implementation of the entrepreneurship-based PjBL model improved student learning outcomes, critical thinking skills, and collaboration. Assessment scores increased from 62 in Cycle I to 83 in Cycle II, representing a 33.87% increase. Evaluation scores increased from 73 to 93, representing a 27.40% increase, while reflection scores increased from 76 to 91, representing a 19.74% increase. Students' critical thinking skills also improved in the focus, reason, inference, situation, clarity, and overview indicators, which were dominated by categories 3 and 4 in Cycle II. Furthermore, students' collaborative skills improved across indicators of shared understanding, taking appropriate action, and team regulation. Based on the research results, it can be concluded that the implementation of the entrepreneurship-based Project-Based Learning (PjBL) model is effective in improving students' critical thinking and collaboration skills in Biology.

Preeclampsia is a pregnancy complication that significantly contributes to maternal and neonatal morbidity and mortality worldwide. Globally, it affects approximately 3–8% of pregnancies and causes more than 70,000 maternal deaths each year. In Indonesia, preeclampsia accounts for around 30% of the 4,151 maternal deaths reported in 2024. In Padang City, there were 254 cases in 2023 and 129 cases in 2024, with Puskesmas Bungus having the highest prevalence (7.2% and 3.77%). This study aimed to analyze the association between body mass index (BMI), history of hypertension, and history of preeclampsia with the incidence of preeclampsia among pregnant women at Puskesmas Bungus, Padang. This study used a quantitative case-control design involving 50 cases and 50 controls. Data were analyzed using chi-square and logistic regression tests. The results showed significant associations between obesity (p=0.031; OR=2.897), history of preeclampsia (p=0.006; OR=13.821), and history of hypertension (p=0.002; OR=17.216) with the incidence of preeclampsia. Multivariate analysis identified history of hypertension as the most dominant factor associated with preeclampsia. This study concludes that obesity, history of hypertension, and history of preeclampsia are significant risk factors for preeclampsia among pregnant women. Strengthening early detection and routine antenatal care for high-risk pregnancies is necessary to reduce maternal complications associated with preeclampsia.

Circulating tumor DNA (ctDNA) has emerged as a promising liquid biopsy biomarker for real-time monitoring of tumor dynamics. In urothelial carcinoma (UC), effective monitoring of treatment response remains a clinical challenge due to the limitations of conventional imaging and invasive procedures. This systematic review aims to synthesize the existing evidence on the association between ctDNA dynamics and treatment response monitoring across various stages and therapeutic settings. A comprehensive systematic review was conducted. We included cohort studies, randomized controlled trials, and meta-analyses that evaluated ctDNA in UC patients undergoing treatment. Data were extracted on patient population, methodology, treatment, sampling strategy, clinical outcomes, and statistical associations. The review encompassed 80 studies. Baseline ctDNA positivity was strongly prognostic, associated with a 4- to 6-fold increased risk of recurrence or death (HR 4.23-6.56). Dynamic ctDNA clearances or significants reduction during treatment, were strongly associated with improved outcomes. Showing hazard ratios for adverse events as low as 0.10-0.31. ctDNA demonstrated time advantages of 53-90 days over radiographic detection. ctDNA is a potent tool for monitoring treatment response in urothelial carcinoma. It provides superior prognostic and offers a significant lead time for detecting treatment failure. Future research must focus on standardizing methodologies and validating ctDNA-guided therapeutic.

Gastroesophageal Reflux Disease (GERD) merupakan gangguan saluran pencernaan di mana isi lambung berulang kali kembali ke kerongkongan, menyebabkan berbagai gejala dan komplikasi. Prevalensi GERD di Indonesia pada tahun 2023 dilaporkan sebesar 42,3% dengan 274.396 kasus. Data rekam medis RSUD Banyumas menunjukkan peningkatan kasus GERD dari 71 kasus (2023) menjadi 118 kasus (2024). Tujuan: Mendeskripsikan penerapan asuhan keperawatan pada pasien Nn. S dengan Gastroesophageal Reflux Disease (GERD) di Ruang Melati RSUD Banyumas. Metode: Studi kasus deskriptif dengan pendekatan proses asuhan keperawatan, dilakukan pada tanggal 27–28 Januari 2026 di Ruang Melati RSUD Banyumas melalui wawancara, observasi, pemeriksaan fisik, studi dokumentasi, dan studi literatur. Hasil: Diagnosis keperawatan yang muncul adalah nyeri akut berhubungan dengan agen pencedera fisiologis (D.0077), nausea berhubungan dengan gangguan pada esofagus (D.0076), dan defisit pengetahuan berhubungan dengan kurang terpapar informasi (D.0111). Intervensi yang dilakukan meliputi manajemen nyeri, manajemen mual, dan edukasi kesehatan. Kesimpulan: Setelah dilakukan implementasi keperawatan selama 2 hari, diagnosis nyeri akut dan nausea teratasi sebagian, sedangkan diagnosis defisit pengetahuan teratasi penuh. Discharge planning dilakukan dengan menganjurkan teknik relaksasi napas dalam, aromaterapi minyak kayu putih, serta modifikasi pola hidup sehat.

Background: Hepatocellular Carcinoma (HCC) is an abnormal cell growth in the liver characterized by increased number of dividing liver cells accompanied by malignant transformation. A common paraneoplastic phenomenon in HCC patients is hypoglycemia, which arises due to hepatic dysfunction impairing gluconeogenesis and glycogenolysis, as well as tumor-mediated IGF-II production. This condition causes hypoglycemia as a primary nursing problem requiring comprehensive nursing care. Objective: To describe the nursing care process for a patient with HCC focusing on blood glucose instability management and knowledge deficit intervention. Methods: This study used a descriptive qualitative method through a case study approach. Data were collected through interview, observation, documentation study, and literature review. Results: Two nursing diagnoses were identified: blood glucose instability related to hepatic dysfunction and knowledge deficit related to lack of information exposure. Nursing interventions performed included hypoglycemia management and disease process education. After 2x24 hours of nursing implementation, both diagnoses were partially resolved, as GDS values remained fluctuating and behavioral change had not been fully achieved. Conclusion: Comprehensive nursing management through routine blood glucose monitoring, dextrose administration, nutritional modification, and health education can improve blood glucose stability and patient knowledge in HCC patients.

The development of an economic activity in a city is often one of the influences on changes in the use of residential space in the surrounding area. One of the phenomena that we can see in big cities in Indonesia is the use of residences as rental housing such as boarding houses and rents aimed especially at workers in foreign areas. This study aims to analyze the use of residential space by the community as temporary residence for employees of Mie Gacoan restaurant in Serang City, Banten, and see how it affects the spatial dynamics of the residential area. This study uses a primary and secondary data-based case study method with a qualitative descriptive approach. The results of the study show that the existence of economic activities around residential areas can encourage an increase in the need for temporary housing for workers in rural areas. This phenomenon makes some people take advantage of their residences by making them rental residences such as boarding houses and rented ones. This can affect the spatial structure of the residential area, such as increasing population density, increasing activities in the residential environment, and the presence of small economic activities by the community. Therefore, this phenomenon states that the development of economic activity in an urban area can trigger changes in the use of space in the surrounding residential area.

The digitalization of tax administration has become one of the Indonesian government's strategic initiatives to improve efficiency, transparency, and taxpayer compliance. However, the implementation of digital tax systems among Micro, Small, and Medium Enterprises (MSMEs), particularly distributor-sector MSMEs in Batam City, still faces various administrative and technical challenges. This study aims to examine the experiences, risk perceptions, and adaptation strategies of distributor MSME actors in responding to the digitalization of tax administration following the implementation of the Harmonization of Tax Regulations Law (UU HPP). The research employed a qualitative approach using a phenomenological method. Data were collected through in-depth interviews with seven distributor MSME owners in Batam City who had utilized digital tax systems such as e-Filing and Coretax. The findings indicate that most business actors still experience limitations in technical understanding, concerns regarding reporting errors, and difficulties adapting to changes in digital tax systems and regulations. To address these challenges, MSME actors developed several adaptation strategies, including the use of tax consultants, hybrid manual-digital bookkeeping systems, and informal assistance through the internet and business networks. This study highlights that the success of tax digitalization requires a more adaptive approach, stable systems, and policies that are aligned with the characteristics of local MSMEs.

Background: Menstruation is a natural physiological process that indicates the functional maturity of the female reproductive system. Menstrual cycle disorders can be influenced by several factors, including stress and obesity. Stress may cause hormonal changes through the hypothalamic-pituitary axis, leading to decreased luteinizing hormone (LH) levels and menstrual irregularities. Obesity can also affect ovarian function and disrupt the menstrual cycle. Objective: To determine the relationship between stress and obesity with menstrual cycle disorders among female adolescents at SMAN 1 Majene in 2026. Methods: This study used an analytical observational design with a cross-sectional approach. Data on stress levels, obesity status, and menstrual cycle disorders were collected simultaneously from 84 female respondents. The chi-square test was used to analyze the relationships among variables. Results: The analysis showed a significant relationship between stress and menstrual cycle disorders (p = .006; α < .05). A significant relationship was also found between obesity and menstrual cycle disorders (p = .002; α < .05). Many obese respondents experienced irregular menstrual cycles. Conclusion: There is a significant relationship between stress and obesity with menstrual cycle disorders among female adolescents at SMAN 1 Majene.

Adolescents face significant barriers in accessing reproductive health services due to fears of privacy breaches and social stigma. In primary healthcare facilities, healthcare professionals are often trapped in a dilemma between the obligation to maintain medical confidentiality based on professional ethics and national regulatory demands requiring parental involvement for underage patients. This study aims to analyze the practice of protecting adolescent patient data privacy at Mardi Saras Primary Clinic and identify the gap between practical implementation and the norms of medical ethics and applicable legal regulations. This study employs a socio-legal research method with a qualitative approach. Data were collected through in-depth interviews with doctors and nurses, observation of service procedures, and study of the clinic's Standard Operating Procedures. The results indicate that although Mardi Saras Primary Clinic has implemented basic confidentiality protocols such as closed consultation rooms, there are substantial weaknesses in informed consent management, which still heavily relies on parental presence for all adolescent cases. This practice is driven by healthcare professionals' fear of legal risks, thereby ignoring the principle of developing autonomy in adolescents. These findings indicate a disparity between rigid administrative compliance and the spirit of protecting adolescent health rights within national regulations. The implication of this study underscores the urgency of developing specific SOPs that are sensitive to adolescent rights, as well as the need for continuous training for healthcare professionals regarding the legal and ethical boundaries of maintaining confidentiality for underage patients without compromising legal safety aspects.

This community service study investigates a marketing training program implemented by theology students of STT Kadesi Bogor at the GPIA Sidoasri congregation in Sumbermanjing Wetan District, Malang Regency, East Java. The program targeted eighteen women members of the congregation to improve their economic capacity through the marketing of low-cost everyday clothing via three channels: door-to-door sales, a small storefront at the church, and online commerce through TikTok. The study applied a pre- test/post-test design evaluated using the Normalized Gain (N-Gain) method to measure changes in knowledge and skill across five indicators: marketing knowledge, selling skills, online media usage, basic financial recording, and entrepreneurial motivation. Results indicated a moderate-to-high N-Gain across all measured indicators, with an average N-Gain score of 0.656 (moderate category), and the highest individual gain in entrepreneurial motivation (0.76, high category). Sales data over the three-month period (January–March 2025) recorded a total profit of Rp1,967,500 across 345 garments sold, representing an income supplement of approximately 27–35% relative to participants' baseline household income for the most active participants. A marked sales decline in February and March was attributed to seasonal demand shifts ahead of Eid al-Fitr, as consumers redirected purchases toward formal Muslim attire. The program demonstrated that congregation-based economic empowerment rooted in a biblical theology of work, stewardship, and the dignity of labor can yield measurable and holistic socioeconomic outcomes for Christian women in rural communities.

Muscle-invasive bladder cancer (MIBC) is an aggressive malignancy associated with high morbidity, reduced survival, and impaired quality of life. Radiotherapy (RT) has been widely used as a bladder-preserving strategy, particularly for patients unsuitable for surgery or systemic chemotherapy. RT may also enhance tumor immunogenicity through programmed death-ligand 1 (PD-L1) upregulation, providing a rationale for combination therapy with immunotherapy. This study aimed to evaluate the effectiveness of combining immunotherapy and radiotherapy in MIBC treatment. A systematic review was conducted following PRISMA 2020 guidelines using the PICO framework. Literature searches were performed in PubMed, Embase, Cochrane, ClinicalTrials.gov, Web of Science, and Scopus databases for studies published between 2016 and 2025. Risk of bias was assessed using the Cochrane Risk of Bias Tool and ROBINS-I. Of 105 identified studies, five met the inclusion criteria and were included in the final analysis. Only one Phase II randomized controlled trial demonstrated low risk of bias in randomization and allocation concealment. ROBINS-I assessment indicated moderate to serious risk in confounding and participant selection domains. Clinical findings showed promising outcomes, with complete response rates ranging from 35%–50% and partial response rates from 25%–40%. Median overall survival ranged from 24–30 months, with favorable disease-free and progression-free survival outcomes. Combined immunotherapy and radiotherapy demonstrate potential to improve survival and disease control in MIBC; however, further rigorous clinical studies are needed to optimize patient-centered treatment strategies.  

This study aims to identify and evaluate the cultural tourism potential of Kalurahan Grogol in Gunungkidul Regency to inform the development of a community-based cultural tourism village. The research employed a qualitative descriptive approach supported by quantitative scoring techniques using a 1–5 Likert scale across four assessment dimensions: cultural value, physical value, tourism value, and experiential value. The analysis applied Du Cros and McKercher’s Market Appeal–Robusticity Matrix to map the market attractiveness and cultural robustness of each cultural asset. Data were collected through semi-structured interviews, observations, and documentation studies of 46 tangible and intangible cultural assets in Kalurahan Grogol. The findings reveal that most cultural assets exhibit moderate to high cultural robustness, indicating that local cultural practices remain active and socially sustained within the community. Prominent cultural assets such as Rasulan, Karawitan Lestari Budoyo, Reog Sedyo Laras, Gejlok Lesung, Sega Berkat, and Tempe Godhong are positioned in Quadrant A1, characterized by high market appeal and high robustness, making them highly potential as leading cultural tourism attractions. Meanwhile, assets in Quadrants B and C present opportunities to develop creative, educational, spiritual, and wellness-based experiential tourism products. The study also finds that several sacred traditions categorized in Quadrant D are more appropriately preserved through non-commercial approaches. The absence of cultural assets in the D3 category indicates that the cultural system of Kalurahan Grogol remains adaptive and regenerative amid modernization. This research contributes theoretically by extending the application of the Market Appeal–Robusticity Matrix into the context of community-based cultural tourism villages. It provides strategic recommendations for sustainable cultural tourism development that remain sensitive to local cultural authenticity.

Vector-borne infectious diseases remain a public health concern, particularly in tropical regions such as Indonesia. Sanitation clinics at public health centers (Puskesmas) play a role in identifying environmental risk factors and planning interventions to support vector-borne disease control. This study aimed to evaluate the performance of sanitation clinics in environmental intervention planning. The method used was a literature review of scientific articles, journals, and related documents published between 2015-2025. Data were analyzed descriptively to identify forms of environmental interventions and their effectiveness. The results showed that sanitation clinics play an important role in environmental health counseling, sanitation inspections, health education, and environmental intervention planning. However, their implementation still faces challenges, including limited numbers of sanitarians, inadequate facilities and infrastructure, and suboptimal environmental interventions. Nevertheless, sanitation clinics continue to contribute to the prevention of environment-based diseases and vector control. Therefore, strengthening resources and improving the quality of intervention planning are necessary to enhance the effectiveness of sanitation clinic programs.